DR. SUNDERAM KODMAN SHETTY M.D., F.A.C.R.O.
NPI 1720061674
Specialist in West Palm Beach, FL

Q: What is Sunderam Shetty's NPI number?

The NPI number for Sunderam Shetty is 1720061674. It was assigned to this individual provider in the NPPES registry on November 23, 2005.

Q: What is Sunderam Shetty's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Q: When was this NPI record last updated?

The NPPES record for Sunderam Shetty was last updated on June 28, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since November 23, 2005

901 45TH ST, KAPLAN CANCER CENTER, ST MARYS HOSPITAL, WEST PALM BEACH, FL 33407(561) 881-2815(561) 881-0951 Get Directions Write a Review

NPPES record last updated: June 28, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Sunderam Kodman Shetty M.d., F.a.c.r.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SUNDERAM KODMAN SHETTY M.D., F.A.C.R.O. (NPI 1720061674) is an individual specialist in West Palm Beach, Florida, licensed in Florida (ME37893) and active in the NPI registry since November 2005.

NPPES Registry Identity

NPI1720061674

Entity TypeIndividualMale

Primary Taxonomy174400000X

Provider Legal NameDR. SUNDERAM KODMAN SHETTYCredential: M.D., F.A.C.R.O.

Location Address901 45TH ST, KAPLAN CANCER CENTER, ST MARYS HOSPITALWest Palm Beach, FL 33407-2413

Mailing Address901 45th St, Kaplan Cancer Center, St Marys HospitalWest Palm Beach, FL 33407-2413 · (561) 881-2815 · Fax (561) 881-0951

Phone(561) 881-2815

Fax(561) 881-0951

Sole ProprietorYes

Enumeration DateNovember 23, 2005

Last NPPES UpdateJune 28, 2010

✔ NPI 1720061674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in FL · ME37893

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

901 45TH ST, West Palm Beach, FL 33407

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Other Identifiers 3

Medicaid061721100FL

Medicare PIN61186YFL

Medicare UPIND65250FL

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STERLING EMERGENCY SERVICES OF FLORIDA PA

Emergency Medicine